Cytochrome P–450 gene and drug interaction analysis in patients referred for pharmacogenetic testing

Hocum, Brian; White, John R.; Heck, Jarrod W.; Thirumaran, Ranjit K.; Moyer, Nicolas; Newman, Richard; Ashcraft, Kristine

doi:10.2146/ajhp150273

Cited by 49 publications

(36 citation statements)

References 7 publications

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“…51 Similarly, in a study published in 2016, researchers identified that 69.1% of 20,534 patients had at least 1 reported drug interaction and, of those interactions determined to be severe, 24.6% were DGIs. 52 Collectively, these data indicate that genetic variations can substantially contribute to MRPs among older adults. These results are clinically important because genetically determined interindividual differences in drug disposition and response can affect clinical outcomes in older adults, whom are more susceptible to therapeutic failures and adverse drug reactions.…”

Section: Discussionmentioning

confidence: 88%

Implementation of a Standardized Medication Therapy Management Plus Approach within Primary Care

et al. 2017

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Purpose: The purpose of this study was to implement a clinical pharmacist-led medication therapy management (MTM) service within a primary-care setting that is enhanced by 1) a clinical decision support system (CDSS) that includes a unique combination of medication risk mitigation factors, which aids the pharmacist in interpreting the medication profile, and 2) pharmacogenomics (PGx) testing.Methods: This was a service implementation study, whereby Medicare beneficiaries were eligible if they were patients of Elmwood Family Physicians, a private family, primary care practice with 2 locations in New Jersey, and were on at least 7 medications. Patients had a medication reconciliation completed by a pharmacist and performed a PGx buccal swab. Patient information was run through a CDSS to aid the pharmacist with screening for multidrug interactions and assessing patient's medication-related risks. The output of the CDSS was used to create recommendations and provide a consult to the physicians. Recommendations were followed up by return of the consult. Primary care physicians (PCPs) are the most frequent prescribers of medications, with over 65% to 75% of medications being prescribed in the primarycare setting. 1,2 Although medications are a critical intervention for the prevention and treatment of medical conditions, they also can be associated with medication-related problems (MRPs). A MRP is This article was externally peer reviewed.

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Section: Discussionmentioning

confidence: 88%

Implementation of a Standardized Medication Therapy Management Plus Approach within Primary Care

et al. 2017

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“…Although not discussed in detail in this review, it is important to consider the role of pharmacogenomics in determining the magnitude of drug‐drug interactions and drug‐drug‐gene interactions—that is, polymorphisms in a metabolic pathway and inhibition or induction of the same or minor pathway . In fact, a cross‐sectional study involving 22,885 patients found that there were approximately 6,900 drug interactions, of which drug‐drug‐gene, drug‐gene, and drug‐drug interactions accounted for 22%, 25%, and 53%, respectively .…”

Section: Resultsmentioning

confidence: 99%

Value of Supportive Care Pharmacogenomics in Oncology Practice

et al. 2018

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Integration of palliative medicine into the cancer care continuum has resulted in increased quality of life and survival for patients with many cancer types. However, suboptimal management of symptoms such as pain, neuropathy, depression, and nausea and vomiting continues to place a heavy burden on patients with cancer. As demonstrated in this theoretical case, pharmacogenomics can have a major effect on clinical response to medications used to treat these conditions. Recognizing the value of supportive care pharmacogenomics in oncology and application into routine practice offers an objective choice for the safest and most effective treatment compared with the traditional trial and error method.

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“…These comments may be based on analysis of a single gene at a time or in combination. The interpretative report might include comments on a single medication, multiple medications, or a disease‐specific set of medications (e.g., cardiology panel) . Disease‐specific medication set reports may not cover the complete clinical importance of the results if the results applied to medications in multiple clinical areas.…”

Section: Reporting Of Resultsmentioning

confidence: 99%

Pharmacogenomics Implementation: Considerations for Selecting a Reference Laboratory

Bell

Obeng

et al. 2017

Pharmacotherapy

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One of the initial steps for implementing pharmacogenomics into routine patient care is selecting an appropriate clinical laboratory to perform the testing. With the rapid advances in genotyping technologies, many clinical laboratories are now performing pharmacogenomic testing. Selection of a reference laboratory depends on whether a particular genotype assay is already performed by an internal health care organization laboratory or only available externally. Other factors for consideration are coverage of genomic variants important for the patient population, technical support, and cost. In some instances, the decision to select a particular reference laboratory may be the responsibility of the clinician who is recommending genomic interrogation. Only limited guidance is available that describes the laboratory characteristics to consider when selecting a reference laboratory. We provide practical considerations for selecting a clinical laboratory for pharmacogenomic testing broadly categorized into four domains: pharmacogene and variant selection; logistics; reporting of results; and test costs along with reimbursement.

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Cytochrome P–450 gene and drug interaction analysis in patients referred for pharmacogenetic testing

Abstract: In a mixed-race population of over 20,000 U.S. patients, CYP gene polymorphisms associated with DDIs and other interaction threats were prevalent, and most individuals were not categorized as normal metabolizers of all five CYP isozymes of interest.

Cited by 49 publications

References 7 publications

Implementation of a Standardized Medication Therapy Management Plus Approach within Primary Care

Implementation of a Standardized Medication Therapy Management Plus Approach within Primary Care

Value of Supportive Care Pharmacogenomics in Oncology Practice

Pharmacogenomics Implementation: Considerations for Selecting a Reference Laboratory

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